Poll: Should we have an index, which includes the length of events, as described in my post?
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AHI and length of events
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Ghandi Offline

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Post: #1
AHI and length of events
Hi everyone,

I have been doing this AHI quest for a couple of months now. With the sleep report from sleepyhead(insert other sofware here) we can always track the length of events and see what may have caused sleep disruption etc.

I noticed that some times there AHI is way higher but the nature of events is very mild. And sometimes IT's the contrary. Very few events but long and most likely disruptive to sleep cycles.

First of all i dont understand why and hypopnea scores as much as an apnea episode if the are different in length , intensity and repercussions. Dont they have a different name for something? I'm thinking th AHI in itself should be protraying that. I'm thinking the algorithm should have a scale or a multiplier of event that are over x amount of time. Let say 10 seconds counts as 1. For 20 seconds * 2 and so on.

Imagine how usefull an index like that would be.

Imagine an idex that could include oxygen desaturation level into account . For those monitoring with oximeter it could evaluate the score of an event according to the desaturation.

I may be missing something rigth now i have the feeling AHI could be improved. Just like rera were integrated into the AHI for RDI.

What do you guys think? good idea? Bad idea? Why?
08-15-2014 12:07 PM
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surferdude2 Offline

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Post: #2
RE: AHI and length of events
I'll vote for "It's a good idea" since I believe the duration of an event is extremely important when it comes to doing damage to the body and disrupting restful sleep. If those smaller duration events don't affect us much, there should be some index that tallies that over and beyond the AHI index which can cause undue worrying. I could be all wet and perhaps a small duration is like a small dose of poison and may have cumulative effects that must be considered. Even so, I'm voting for adding an additional index for whatever reason since you can't have too much data, be too skinny, be too pretty or have too much money.
08-15-2014 12:24 PM
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Ghandi Offline

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Post: #3
RE: AHI and length of events
hehe at least one person voted surferdude2 Smile
08-16-2014 06:39 AM
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JimZZZ Offline

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Post: #4
RE: AHI and length of events
I think you have a good idea. Sometimes the duration of my events are much longer than my usual 10-15 seconds and I don't know what to make of it. It seems obvious that duration should somehow impact an overall index that represents the patient's degree of success with PAP.
08-17-2014 05:33 AM
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archangle Offline
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Post: #5
RE: AHI and length of events
The medical mafia is all about doing the minimal amount of work needed to ring the cash register. Also about keeping things mysterious in order to do more in-lab $leep $tudie$.

AHI is a useful number. If you keep it low, things are probably pretty good. It's one of those things that "good enough for government work."

Someone would have to do a lot of work and research to come up with a better number. Then they'd have to get the sleep medicine community to actually use it.

Good idea. Probably not likely to catch on.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
08-17-2014 04:30 PM
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surferdude2 Offline

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Post: #6
RE: AHI and length of events
I found it odd that my pulmonologist/sleep certified doctor told me that my audio recordings of me gasping for air and failing to breathe for periods of time for as long as 70 seconds were nothing to worry about. His remark was, "That will happen." His only concern was that they should not occur more often than 5 times per hour. Geez, I would think four 70 second strangulations in a hour would be worth considering but it seems that the length of the incident is not looked at much. I suppose that if you had only one event but it lasted 5 minutes it would be worthy of special consideration (by the coroner, no doubt).
08-17-2014 04:41 PM
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Ghandi Offline

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Post: #7
RE: AHI and length of events
(08-17-2014 04:41 PM)surferdude2 Wrote:  I found it odd that my pulmonologist/sleep certified doctor told me that my audio recordings of me gasping for air and failing to breathe for periods of time for as long as 70 seconds were nothing to worry about. His remark was, "That will happen." His only concern was that they should not occur more often than 5 times per hour. Geez, I would think four 70 second strangulations in a hour would be worth considering but it seems that the length of the incident is not looked at much. I suppose that if you had only one event but it lasted 5 minutes it would be worthy of special consideration (by the coroner, no doubt).

Seriously ..that should be criminal. It the first place they treat apnea because desaturation is harmfull. I dont understand why a doctor would't be bothered with 70 seconds events.
08-17-2014 07:06 PM
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surferdude2 Offline

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CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
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Post: #8
RE: AHI and length of events
(08-17-2014 07:06 PM)Ghandi Wrote:  Seriously ..that should be criminal. It the first place they treat apnea because desaturation is harmfull. I dont understand why a doctor would't be bothered with 70 seconds events.

I feel the same way. That's why I'm considering replacing him and looking for someone more concerned about the patient and who gives more credibility to what the patient says. This jerk as much as told me that any recording I do will not be useful since it's not recognized as being from a certified source. It's not like I was applying for a grant, I just wanted him to know how my condition was affecting me and he countered by saying I only had 1.9 events in an hour during my sleep test and couldn't qualify for any treatment that Medicare would pay for. I told him "to hell with Medicare, I want something done now". It had been 5 months since my first visit with him and I was very desperate from lack of sleep and getting so depressed that life didn't seem worthwhile anymore.

I suppose I should be grateful that he finally agreed to write me a prescription so I could buy a CPAP machine out of pocket, which I have done. The S9 rendered a 16.9 AHI on my first session with it but I doubt that will impress the good doctor since the machine isn't one of his certified sources. I didn't sleep hardly at all in the certified sleep lab study so I don't see how they arrived at the 1.9 per hour figure when I slept less than 15 minutes tops. My next appointment is for Sept. 2nd so I've got some time to ponder his fate as my medical adviser. I have managed to titrate my events down to 5.7 and am sleeping much better. I now have hopes of returning to my old jolly self and worrying about something other than how I may sleep on any particular night.

Maybe next time I do a sleep test I should just hold my breath and grunt 10 times per hour and game the system. Bigwink
(This post was last modified: 08-17-2014 07:45 PM by surferdude2.)
08-17-2014 07:38 PM
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Ghandi Offline

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Post: #9
RE: AHI and length of events
Well Doctors often think they are God like. Not all of them but yeah ..they need to show off they know more and justify their long studies , like if the salary wasn't enough. Often patient are number and their authoritary position provide them with so many maners of showing how powerfull they are. They do take care of health which is probably the most important thing for humans.

About the test, good idea since they count your ahi while you not asleep they should not see a difference if you hold your breath Smile. Just dont hold it for too long Wink

Hang in there, the worse is probably behind.

I had the cpap for such a short time and i dont recall ever beeing that healty and energized. This thing changed my life. i would just miserably hang through the day and crave to get home to sleep and sleep almost all weekends too for like 15 years. I dont ever want to feel that way again.
08-17-2014 08:39 PM
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Sparkle Offline

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Post: #10
RE: AHI and length of events
(08-17-2014 08:39 PM)Ghandi Wrote:  I had the cpap for such a short time and i dont recall ever beeing that healty and energized. This thing changed my life. i would just miserably hang through the day and crave to get home to sleep and sleep almost all weekends too for like 15 years. I dont ever want to feel that way again.

I'm with you! I am approaching my one month anniversary with auto CPAP. I feel fortunate in that as best as I can tell it went 2.5 to 3 years undiagnosed/untreated. I hear you when you talk about sleeping through the weekends. I lived for weekends and to sleep. Just to make myself feel better about not "wasting away time" I would gather up my energy on Saturday and Sunday mornings and go to the lake and sleep there. Now that I think of it i must have been quite a sight if I was snoring - lol.

Congrats and here's to better days and nightr!Big Grin

PS I have my follow up in Ten days

   
02-09-2015 07:31 PM
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